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Issues of intervention aimed at preventing prospective surplus of physicians in Japan
1Department of Health Economics and Policy, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Insights
Japan
Area of Science:
- Health Policy
- Medical Economics
- Physician Workforce Planning
Background:
- Japan faces a potential physician surplus, prompting government intervention.
- Past Ministry of Health and Welfare (MHW) policies aimed to reduce medical student enrollment.
- These interventions have not achieved their intended reduction targets.
Purpose of the Study:
- To analyze the reasons behind the failure of MHW's physician manpower policy.
- To evaluate the appropriateness of reducing overall medical student numbers.
- To provide recommendations for future physician workforce planning in Japan.
Main Methods:
- Review of past MHW physician supply and demand forecasts.
- Analysis of government policies for controlling physician training.
- Preliminary projection of specialty-specific physician service demand.
Main Results:
- Policy implementation was hindered by conflicts among interest groups.
- A lack of precise projections for physician services impacted policy effectiveness.
- The MHW's approach to reducing medical student numbers proved inadequate.
Conclusions:
- Re-evaluation of the MHW policy to reduce overall medical student enrollment is necessary.
- Accurate and precise projections of future physician demand are crucial.
- Consolidating data for robust demand forecasting is the first step for effective policy.
Objectives:
In Japan, regulatory intervention aimed at preventing a prospective surplus of physicians is an important medical issue. The study committees organized by the Ministry of Health and Welfare (MHW) in 1986, 1993 and 1998, concluded that the number of physicians would exceed demand for their services in the future. As a result, the government planned to reduce the number of medical students. However, MHW has not been successful in the intervention so far, as shown by the fact that their initial plan for a 10% reduction in the number of students enrolled in medical school has not been attained. In this paper, we examine why the MHW policy failed.
Methods:
We reviewed those forecasts performed by past MHW study committees and examined whether the government policy of controlling physician training was appropriate. Additionally, we did a preliminary projection of specialty-specific demand for physician services as a reference for future physician manpower policies in Japan.
Results:
We found that both conflicts among various interest groups and a lack of precise projections of physician services hampered the proper formation and implementation of a physician manpower policy in Japan.
Conclusions:
It might be necessary to examine the appropriateness of the MHW policy in reducing the overall number of students enrolled in medical schools. As a first step in formulating and implementing a physician manpower policy, we should begin to consolidate the necessary data to conduct precise and proper projections of future physician demand.